Is TCM syndrome differentiation difficult? Actually, it's not difficult.
Syndrome Differentiation = Qualitative+Positioning
Deficiency of spleen qi
What is the deficiency of temper? We can completely divide it.
1. Qualitative: Qi deficiency
Let's briefly talk about the concepts we are familiar with at ordinary times. Qi in traditional Chinese medicine is slightly close to function, and it is very close to the energy we usually understand, although it cannot be completely translated.
Think of it this way first. Qi deficiency is nothing more than functional decline and lack of energy. In a word, it is nothing more than physical and mental exhaustion. If anyone says that I feel tired easily and have no spirit, it must be qi deficiency.
On this basis, the tongue is pale (remember this first). Pulse condition: Aren't you qi-deficient? Don't you have enough energy? Therefore, the pulse condition is characterized by weakness, which is generally manifested as weak pulse.
Note: if you only show the above symptoms, you can say qi deficiency at most, not spleen deficiency. Why? Because you lack the symptoms of localization.
2. location: spleen
Spleen governs transport and transformation. When you can't move it, one thing is still there, and the other thing hasn't been shipped yet. Therefore, the first group of symptoms are abdominal distension and anorexia (different textbooks may have different expressions, such as anorexia, poor diet and loss of appetite), which can neither be digested nor transported.
Also, as we said, the spleen goes up, and the subtle Shui Gu should go up. If it is not transported away, Shui Gu will go down subtly, that is, loose stool, and the stool is like mud.
Combined with the above two groups of symptoms, we can make a diagnosis: it is characterized by qi deficiency and positioned as spleen.
This is a short time. If it takes a long time, the symptoms will be different.
Isn't spleen metaplasia qi and blood? Qi and blood are not enough to nourish, and you can go further, such as slimming and muscle weakness. This corresponds to the spleen dominating the muscles and the spleen dominating the limbs.
Mild myasthenia gravis, severe myasthenia gravis in western medicine.
No matter whether you are light or heavy, myasthenia gravis is related to muscle weakness in traditional Chinese medicine, and it must be spleen deficiency. As for my spleen tonic effect, it depends on the severity of your illness.
I dare not say that it is good to strengthen the spleen with Chinese medicine, but it is definitely better to strengthen the spleen than not to strengthen the spleen. Mild spleen strengthening is definitely effective, and moderate spleen strengthening can be combined with western medicine, so it should be said that the effect is also good.
In fact, the first group of symptoms above can be shared.
If you remember the eight-character mantra of "listlessness, listlessness, and laziness in speech", it is easy to deduce what is deficiency of kidney-qi. Mental fatigue, shortness of breath, laziness, pale tongue and weak pulse, followed by backache and nocturia, located in the kidney.
Another is that he is depressed and always wants to sleep. Deficiency of heart qi
Therefore, seeing "exhaustion of spirit, lack of qi and laziness in speaking", the essence of qi deficiency has been revealed, and the next step is positioning.
Spleen yang deficiency
After talking about spleen deficiency, let's talk about spleen yang deficiency.
If you haven't heard of the theory of Yin and Yang, then here we can first understand this Yang as the sun. Yang deficiency is like lack of sunshine. The most direct manifestation of insufficient sunshine is insufficient brightness and heat.
1. Yang deficiency &; Deficiency of vital qi
The relationship between yang deficiency and qi deficiency is actually very simple. Yang deficiency can be roughly considered as qi deficiency+cold syndrome. Yang deficiency also has the same function decline, but that's because yang deficiency. Yang has a feeling of heat, indicating that it is not hot enough. Just add a cold image.
For example, cold limbs are the image of cold, even if you say that I am not so typical, then abdominal cold will do; You said that I am not as cold as my lower abdomen, which is ok. I can't stand the cold, I can't stand the cold, I can stand the warm, which in turn is the image of cold.
Therefore, on the basis of qi deficiency symptoms, if you have one of the above-mentioned yang deficiency symptoms, your diagnosis is not spleen deficiency, but spleen yang deficiency.
Chinese medicine has tonic medicine and tonic medicine, which are clearly divided.
But if you make a mistake, it is obviously spleen-yang deficiency and spleen-qi deficiency. Is it effective? Effective. At least some declining functions can be improved. At best, you said that the improvement of your cold symptoms was not so clear.
But if you say that your temper is weak, do you think it is spleen-yang deficiency? Some symptoms can be improved, but I am a little angry after taking the medicine. Because I don't need to be so warm, although your symptoms have improved, it is too warm, because the cold symptoms of spleen deficiency are not clear, and it is easy to get angry with drugs that are too warm.
Yang deficiency has a characteristic that all secretions and excretions are cold. For example, when you have a cold, the yellow expectoration is hot and the white expectoration is cold; The yellow and smelly stool is damp and hot, and the stool is cold and wet; Yellow urine is hot and clear urine is cold.
2. Don't melt the granules after they are finished.
There is another symptom here, called the end of the valley. I pull whatever I eat, for example, when I eat vegetables, I see rice grains and vegetable residues when I pull them out.
What you eat is not qi deficiency but yang deficiency of traditional Chinese medicine. Why is it yang deficiency? Let's make an analogy. When cooking, you put water and rice, but there is no fire at the bottom of the pot. It's out, rice is still rice, water is still water, and the rice is not cooked yet. There is no fire at the bottom of the pot, which means yang deficiency.
3. Transport water and liquids
Transportation of water and liquid can be said to be an extension of transportation of Shui Gu. What we eat, besides solid food, actually contains water. Its operation mode is basically the same as that of Yunhua Shui Gu.
Spleen governs transport and transformation. If water comes in, this transformation is not difficult, because unlike solid food, it also has a transformation process, so the focus is on transportation.
Still the same, through the gastrointestinal tract, and then how to transport it? Here is a concept that modern medicine does not have, called "triple energizer".
-What is triple energizer?
Beginners who need morphological structure as a guide can probably understand this.
Triple energizer is similar to the gap between tissues and cells in our body cavity. Wherever there is a gap, it goes, but the real Chinese medicine understands that it is not so real.
What is its function? It is a channel through which gas flows with water and liquid. You must not understand it as a specific pipeline, such as lymphatic vessels. This is not reliable.
Think about it, there is no such thing as qi in western medicine, but if there is qi in the body, its operation is dispersed, and you should not have a specific pipeline to restrict it. Meridian is not a pipeline, but a channel with a fixed relative route for the movement of qi.
Besides, water is not. Do you think there are any pipes that restrict the flow of water in them?
Although you say that there is water in lymph and blood vessels, it is not limited to this. It can go in and out freely. You also have tissue fluid and cell fluid.
So this "triple focus" can only be explained by empty things, and you can't materialize it.
Water is transported to the lungs, and the lungs declare descending, ascending outward, descending inward, for the use of the five internal organs. After being used, it has another way. Where are you going? Go to the kidney, because the kidney will urinate.
As for this whole process, I will only talk about the general frame structure here (the real development is in the part of qi, blood and body fluid).
Then another function is that the spleen is transported to the whole body for human use.
4. Water-liquid metabolic disorder
In fact, there are only two possibilities for Chinese medicine. One possibility is that there is insufficient water and body fluid, which belongs to the category of yin deficiency. The second is that there is more water. If there is more water, there are four products, namely water, dampness, phlegm and drinking. These four things should be close to the same kind, but the symptoms are not exactly the same.
Water is edema, for example, the kind that presses the nest is called edema; There is ascites. Many people may say that ascites is not in the liver system.
You know that the liver system comes from the concept of western medicine, and it is indeed the liver system, but in Chinese medicine, your water appears in the abdomen, which has a lot to do with the spleen system besides the liver system.
Whether you have water, dampness or phlegm, the treatment ideas are similar, mostly related to the spleen.
Huangdi Neijing says that "all dampness and distension belong to the spleen", and Chinese medicine also says that "spleen is the source of phlegm". In clinical manifestations, when encountering water, dampness, phlegm and drinking, it is necessary to strengthen the spleen.
Ancient literati also had a bad writing habit, saying that "words are not surprising and never stop" often exaggerated the degree. Therefore, the accurate expression of the last sentence should be that "all wet swelling" is mostly related to the spleen, not all.
At the same time, there are lung, spleen and kidney, which are closely related to water-liquid metabolism.
When considering a specific problem, Chinese medicine is actually very clear: kidney, spleen or lung? But whether it is lung, spleen and kidney, I am afraid it is related to spleen.
For patients who say A at most, the lung may have the greatest weight, followed by spleen and kidney. Patients in B are kidney first, spleen second and lung third; Patients with C are mainly spleen.
But no matter what you do, the spleen in the middle can't be completely separated, which is related to it, so this solves most of it.